Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-24T17:59:58.400Z Has data issue: false hasContentIssue false
  • English
  • Français

Decubital shoulder ulcers in sows: a review of classification, pain and welfare consequences

Published online by Cambridge University Press:  22 November 2010

M. S. Herskin ,
M. K. Bonde ,
E. Jørgensen  and
K. H. Jensen
M. S. Herskin*
Affiliation:
Faculty of Agricultural Sciences, Department of Animal Health and Bioscience, Aarhus University, PO Box 50, DK-8830 Tjele, Denmark
M. K. Bonde
Affiliation:
Faculty of Agricultural Sciences, Department of Animal Health and Bioscience, Aarhus University, PO Box 50, DK-8830 Tjele, Denmark
E. Jørgensen
Affiliation:
Faculty of Agricultural Science, Department of Genetics and Biotechnology, Aarhus University, PO Box 50, DK-8830 Tjele, Denmark
K. H. Jensen
Affiliation:
Faculty of Agricultural Sciences, Department of Animal Health and Bioscience, Aarhus University, PO Box 50, DK-8830 Tjele, Denmark
*
†E-mail: [email protected]
Get access

Abstract

Decubital shoulder ulcers are lesions on the shoulders of sows kept in production systems, reported to have a relatively high prevalence, and to some extent be comparable with human pressure ulcers. In sows, the ulcers are caused by pressure inflicted by the flooring, leading to oxygen deficiency in the skin and the underlying tissue. This paper reviews existing knowledge about decubital shoulder ulcers in sows, focusing on the pathogenesis, classification and consequences in terms of pain and animal welfare. On the basis of available human as well as animal literature, we describe the primary causal factors, underlying mechanisms, suggested direction of progression as well as temporal development. We review suggested scales for the classification of decubital shoulder ulcers, and argue that none of these are useful for the classification of decubital shoulder ulcers in live sows. The knowledge of the welfare consequences of decubital shoulder ulcers is limited. On the basis of the tissue structures that are involved, we assume that the development and presence of decubital shoulder ulcers in sows are a painful and prolonged condition. It is concluded that the extent of the welfare problem related to decubital shoulder ulcers cannot be fully determined until a valid ante-mortem classification system is available, and knowledge about the duration of the condition (including the various stages), as well as the possible consequences in terms of pain or discomfort have been established.

Keywords

sowpainlesionwelfarepathology
Type
Review
Information
animal , Volume 5 , Issue 5 , 04 April 2011 , pp. 757 - 766
Copyright
Copyright © The Animal Consortium 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ankrom, M, Bennett, RG, Sprigle, S, Langemo, D, Black, JM, Berlowitz, DR, Lyder, CH 2005. Pressure-related deep tissue injury under intact skin and the current pressure ulcer staging systems. Advances in Skin & Wound Care 18, 35–42.CrossRefGoogle ScholarPubMed
Anonymous 2003. Danish Veterinary Health Council: statements concerning shoulder ulcerations in sows (In Danish). Ministry of Food, Agriculture and Fisheries, Danish Veterinary and Food Administration, Denmark, 2pp.Google Scholar
Anonymous 2007. Danish Veterinary Health Council. Statement regarding shoulder ulcers in sows based on questions (in Danish). Ministry of Food, Agriculture and Fisheries, Danish Veterinary and Food Administration, Denmark, 3pp.Google Scholar
Arendt-Nielsen, L 2003. Measuring pain. In Pain – a textbook (in Danish) (eds TS Jensen, JB Dahl and L Arendt-Nielsen), pp. 37–54. FADL Publishing, Copenhagen, Denmark.Google Scholar
Aronovitch, SA 1999. Intraoperatively acquired pressure ulcer prevalence: a national study. Journal of Wound Ostomy and Continence Nursing 26, 130–136.Google ScholarPubMed
Baustad, BM, Fredriksen, B 2006. Prevalence and prevention of decubital shoulder ulcers in Norwegian sows. The Proceedings of the 18th International Pig Veterinary Society Congress, Copenhagen, Denmark, 485pp.Google Scholar
Bermark, S, Zimmerdal, V, Müller, K 2003. Prevalence investigation of bed sours in somatic hospital wards (In Danish). Bispebjerg Hospital, Denmark, 28pp.Google Scholar
Black, JM 2005. Moving toward consensus on deep tissue injury and pressure ulcer staging. Advances in Skin and Wound Care 18, 415–421.CrossRefGoogle ScholarPubMed
Bliss, MR 1992. Acute pressure area care: Sir James Paget’s legacy. Lancet 339, 221–223.CrossRefGoogle Scholar
Bonde, M 2008. Prevalence of decubital shoulder lesions in Danish sow herds (In Danish). Internal Report 12, University of Aarhus, Faculty of Agricultural Sciences, 8pp.Google Scholar
Bouten, CV, Oomens, CW, Baaijens, FP, Bader, DL 2003. The etiology of pressure ulcers: skin deep or muscle bound? Archives of Physical Medicine and Rehabilitation 84, 616–619.CrossRefGoogle ScholarPubMed
Boyle, LA, Leonard, FC, Lynch, PB, Brophy, P 1999. Prevalence and severity of skin lesions in sows housed individually during the production cycle. Irish Veterinary Journal 52, 601–605.Google Scholar
Broom, DM 1988. The scientific assessment of animal welfare. Applied Animal Behaviour Science 20, 5–19.CrossRefGoogle Scholar
Christensen, G 2003. Shoulder lesions in sows registered at meat inspection and by clinical examination (In Danish). Danish Pig Production, Report 633, 7pp.Google Scholar
Christensen, G, Wachmann, H, Enøe, C 2002. Decubital ulcers in sows. The Proceedings of the Danish Pig Veterinary Society, Vejle, Denmark, 8pp.Google Scholar
Cleveland-Nielsen, A, Christensen, G, Ersbøll, AK 2004. Prevalences of welfare-related lesions at post-mortem meat-inspection of Danish sows. Preventive Veterinary Medicine 64, 123–131.CrossRefGoogle ScholarPubMed
Damgaard, BM, Malmkvist, J, Pedersen, LJ, Jensen, KH, Thodberg, K, Jørgensen, E, Juul-Madsen, HR 2009. The effects of floor heating on body temperature, water consumption, stress response and immune competence around parturition in loose-housed sows. Research in Veterinary Science 86, 136–145.CrossRefGoogle ScholarPubMed
Daniel, KR, Priest, DL, Wheatley, DC 1981. Etiologic factors in pressure sores: an experimental model. Archives of Physical Medicine and Rehabilitation 62, 492–497.Google ScholarPubMed
Davies, PR, Morrow, WE, Miller, DC, Deen, J 1996. Epidemiological study of decubital ulcers in sows. Journal of the American Veterinary Medical Association 208, 1058–1062.CrossRefGoogle ScholarPubMed
Davies, PR, Morrow, WE, Rountree, WG, Miller, DC 1997. Epidemiological evaluation of decubital ulcers in farrowing sows. Journal of the American Veterinary Medical Association 210, 1173–1178.CrossRefGoogle ScholarPubMed
De Koning, R 1985. On the well-being of dry sows. PhD, the University of Utrecht.Google Scholar
Dinsdale, SM 1974. Decubitus ulcers: role of pressure and friction in causation. Archives of Physical Medicine and Rehabilitation 55, 147–152.Google ScholarPubMed
Dray, A 1995. Inflammatory mediators of pain. British Journal of Anaesthesia 75, 125–131.CrossRefGoogle ScholarPubMed
Dyce, KM, Sack, WO, Wensing, JG 2002. Textbook of Veterinary Anatomy, 3rd edition. Saunders, St Louis, Missouri, USA.Google Scholar
Fruergaard, M 2005. Reduce the number of shoulder ulcers using through prevention and treatment (In Danish). Danish Pig Production, Report 0513, 6pp.Google Scholar
Gottrup, F 2002. Pain and wounds. In Wounds – background, diagnosis and treatment (In Danish) (ed. F Gottrup and L Olsen), pp. 86–95. Munksgaard Publishers, Denmark.Google Scholar
Gregory, NC 1998. Physiological mechanisms causing sickness behaviour and suffering in diseased animals. Animal Welfare 7, 293–305.CrossRefGoogle Scholar
Haoli, MJ 1998. Classification and grading of pressure sores. Professional Nurse 13, 669–672.Google Scholar
Harvey-Clark, CJ, Gilespie, K, Riggs, KW 2000. Transdermal fentanyl compared with parenteral buprenorphine in post-surgical pain in swine: a case study. Laboratory Animals 34, 386–398.CrossRefGoogle ScholarPubMed
Hassing, AG, Nielsen, NP 2000. Shoulder ulcers (In Danish), InfoSvin, Database of Danish Pig Production, Denmark. Retrieved June 30, 2010, from http://www.infosvin.dkGoogle Scholar
Havn, KT, Poulsen, H, Enøe, C, Nielsen, JP 2004. Risk factors for shoulder ulcers in sows in a Danish sow herd (In Danish). Dansk Veterinærtidsskrift 87, 13–17.Google Scholar
Herskin, MS, Ladewig, J, Arendt-Nielsen, L 2009. Measuring cutaneous thermal nociception in group-housed pigs using laser technique – effects of laser power output. Applied Animal Behaviour Science 118, 144–151.CrossRefGoogle Scholar
Høgedal, P, Pedersen, B 2007. Examination of sows with protruding withers (In Danish). Newsletter, PigVet, Viborg, Denmark. Retrieved June 30, 2010, from http://www.pigvet.dkGoogle Scholar
Ivarsson, E, Mattson, B, Lundeheim, N, Holmgren, N 2009. Decubital shoulder ulcers – prevalence and risk factors (In Swedish). Svenska Pig, Report 42, 8pp.Google Scholar
Jensen, RM 2002. Shoulder ulcers in sows – a pilot study (In Danish). MSc thesis, University of Copenhagen.Google Scholar
Jensen, HE 2008. Shoulder ulcers in sows – clarifying comments (In Danish). Dansk Veterinærtidsskrift 18, 27–30.Google Scholar
Jensen, HE 2009. Investigation into the pathology of shoulder ulcerations in sows. Veterinary Record 165, 171–174.CrossRefGoogle ScholarPubMed
Jensen, TS, Sindrup, SH 2003. Neuropathic pain. In Pain – a textbook (in Danish) (ed. TS Jensen, JB Dahl and L Arendt-Nielsen), pp. 171–182. FADL Publishing, Copenhagen, Denmark.Google Scholar
Jensen, HE, Svendsen, O 2006. Decubital shoulder ulcers in sows – pathogenesis, graduation and comparative aspects (In Danish). Dansk Veterinærtidsskrift 13, 14–16.Google Scholar
Jensen, TS, Dahl, JB, Arendt-Nielsen, L, Bach, FW 2003. Pain Physiology. In Pain – a textbook (in Danish) (ed. TS Jensen, JB Dahl and L Arendt-Nielsen), pp. 23–36. FADL Publishing, Copenhagen, Denmark.Google Scholar
Julius, D, Basbaum, AI 2001. Molecular mechanisms of nociception. Nature 413, 203–210.CrossRefGoogle ScholarPubMed
Jørgensen, B 2004. Pressure ulcers (In Danish). Månedsskrift for Praktiserende Lægegerning 82, 181–190.Google Scholar
Kaiser, M, Mose, K, Alban, L 2006. Which sows get shoulder ulcers? Danish Pig Production, Report 0620, 7pp.Google Scholar
Kaiser, M, Bach-Mose, K, Alban, L 2007. Risk factors for shoulder ulcers in sows (In Danish). Dansk Veterinærtidsskrift 1, 20–26.Google Scholar
KilBride, AL, Gillman, CE, Green, LE 2009. A cross sectional study of the prevalence, risk factors and population attributable fractions for limb and body lesions in lactating sows on commercial farms in England. BMC Veterinary Research 5, 30.CrossRefGoogle ScholarPubMed
Knauer, M, Stalder, KJ, Karriker, L, Baas, TJ, Johnson, C, Serenius, T, Layman, L, McKean, JD 2007. A descriptive survey of lesions from cull sows harvested at two Midwestern US facilities. Preventive Veterinary Medicine 82, 198–212.CrossRefGoogle ScholarPubMed
Kokate, JY, Leland, KJ, Held, AM, Hansen, GL, Kveen, GL, Johnson, BA, Wilke, MS, Sparrow, EM, Iaizzo, PA 1995. Temperature-modulated pressure ulcers: a porcine model. Archives of Physical Medicine and Rehabilitation 76, 666–673.CrossRefGoogle ScholarPubMed
Le, KM, Madsen, BA, Barth, PW 1984. An in-depth look at pressure sores using monolithic silicon pressure sensors. Plastic and Reconstructive Surgery 74, 745–756.CrossRefGoogle Scholar
Leigh, IH, Bennett, G 1994. Pressure ulcers: prevalence, etiology, and treatment modalities. American Journal of Surgery 167, 25S–30S.CrossRefGoogle ScholarPubMed
Littledike, ET, Witzel, DA, Riley, JL 1979. Body temperature changes in sows during the periparturient period. Laboratory Animal Science 29, 621–624.Google ScholarPubMed
Lowthian, PT 2005. Trauma and thrombosis in the pathogenesis of pressure ulcers. Clinical Dermatology 23, 116–123.CrossRefGoogle ScholarPubMed
Lund, M 2003. Shoulder ulcers in sows – pathoanatomical characteristic, and aspects relevant for meat control and ethics (In Danish). MSc thesis, The University of Copenhagen.Google Scholar
Lund, M, Aalbæk, B, Jensen, HE 2003. Decubital shoulder ulcers in sows – an ethical problem (In Danish). Dansk Veterinærtidsskrift 86, 8–11.Google Scholar
Lundgren, H, Zumbach, B, Lundeheim, N 2009. Shoulder sores are inherited. Proceedings of the 61st Congress of the European Association for Animal Production, August 24 to 27, Barcelona, Spain, 481pp.Google Scholar
Maklebust, J, Sieggreen, MY 1996. Pressure ulcers: guidelines for prevention and nursing management, 2nd edition . Springhouse Corporation, Springhouse, PA, USA.Google Scholar
McGavin, MD, Zachary, JF 2007. Pathological basis of veterinary diseases, 4th edition. Mosby Elsevire, St Louis, MO, USA.Google Scholar
Morris, JR, Hurnik, JF, Friendship, RM, Buhr, MM, Evans, NM, Allen, OB 1997. The effect of the Hurnik–Morris system on sow locomotion, skin integrity, and litter health. Journal of Animal Science 75, 308–310.CrossRefGoogle ScholarPubMed
National Pressure Ulcer Advisory Panel 2007. Pressure ulcers stages revised by NPUAP. Retrieved June 30, 2010, from http://www.npuap.orgGoogle Scholar
Nielsen, NP, Vestergaard, K 2003. A note on shoulder ulcers in sows (In Danish), Danish Pig Production, Report 0324, 3pp. .Google Scholar
Reese, DE, Straw, BE, Waddell, JM 2005. Shoulder ulcers in sows and their prevention. Nebraska Swine Report. Retrieved June 30, 2010, from http://www.thepigsite.comGoogle Scholar
Rolandsdottor, E, Westin, R, Algers, B 2009. Maximum lying bout duration affects the occurrence of shoulder lesions in sows. Acta Veterinaria Scandinavica 51, 44.CrossRefGoogle Scholar
Russell, L 2002. Pressure ulcer classification: defining early skin damage. British Journal of Nursing 11, 33–41.CrossRefGoogle ScholarPubMed
Seiler, WO, Stähelin, HB 1986. Recent findings on decubitus ulcer pathology: implication of care. Geriatrics 441, 47–60.Google Scholar
Shea, JD 1975. Pressure sores – classification and management. Clinical Orthopaedics and Related Research 112, 89–100.CrossRefGoogle Scholar
Strathe, J 2007. Shoulder lesions in Danish sows – an abattoir survey with emphasis on the relation between clinical signs and post-mortem registrations. MSc, thesis, The University of Copenhagen.Google Scholar
Sugarman, B, Hawes, S, Musher, DM, Klima, M, Young, EJ, Pircher, F 1983. Osteomyelitis beneath pressure sores. Archives of Internal Medicine 143, 683–688.CrossRefGoogle ScholarPubMed
Sørensen, G 2009. Thirty percent lower risk of decubital shoulder ulcers after increasing the number of daily feedings (In Danish). Danish Pig Production, Report 847, 13pp.Google Scholar
Thorup, F 2006. Back fat at farrowing affects the frequency of shoulder lesions. The Proceedings of the Congress of the International Pig Veterinary Society, Copenhagen, Denmark, 486pp.Google Scholar
Vandeberg, JS, Rudolph, R 1995. Pressure (decubitus) ulcers: variation in histopathology – a light and electron microscope study. Human Pathology 26, 195–200.CrossRefGoogle Scholar
Vermillion, C 1990. Operating room acquired pressure ulcers. Decubitus 3, 26–30.Google ScholarPubMed
Vestergaard, K, Fruergaard, M, Nielsen, NP, Madsen, MT 2005. Decubital shoulder ulcers (In Danish). InfoSvin, Database of Danish Pig Production, Denmark. Retrieved June 30, 2010, from http://www.infosvin.dkGoogle Scholar
Vestergaard, K, Kaiser, M, Petersen, LB, Bækbo, P, Alban, L, Toft, N, Madsen, KK, Friis, CR 2007. Examination of sows with shoulder lesions in two slaughter houses (In Danish). Danish Pig Production, Report 798, 12pp.Google Scholar
Witkowski, JA, Parish, LC 1982. Histopathology of the decubitus ulcer. Journal of the American Academy of Dermatology 6, 1014–1021.CrossRefGoogle ScholarPubMed
Yarkony, GM, Kirk, PM, Carlson, C, Roth, EJ, Lovell, L, Heinemann, A, King, R, Lee, MY, Betts, HB 1990. Classification of pressure ulcers. Archives of Dermatology 126, 1218–1219.CrossRefGoogle ScholarPubMed
Zurbrigg, K 2006. Sow shoulder lesions: risk factors and treatment effects on an Ontario Farm. Journal of Animal Science 84, 2509–2514.CrossRefGoogle Scholar